Measure #182 (NQF 2624): Functional Outcome Assessment National Quality Strategy Domain: Communication and Care Coordination

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "Measure #182 (NQF 2624): Functional Outcome Assessment National Quality Strategy Domain: Communication and Care Coordination"

Transcription

1 Measure #182 (NQF 2624): Functional Outcome Assessment National Quality Strategy Domain: Communication and Care Coordination 2016 PQRS OPTIONS FOR INDIVIDUAL MEASURES: CLAIMS, REGISTRY DESCRIPTION: Percentage of visits for patients aged 18 years and older with documentation of a current functional outcome assessment using a standardized functional outcome assessment tool on the date of the encounter AND documentation of a care plan based on identified functional outcome deficiencies on the date of the identified deficiencies INSTRUCTIONS: This measure is to be reported each visit for patients seen during the 12 month reporting period. The functional outcome assessment is required to be current as defined in the definition section. This measure may be reported by eligible professionals who perform the quality actions described in the measure based on the services provided and the measure-specific denominator coding. Measure Reporting via Claims: CPT codes and patient demographics are used to identify patients that are included in the measure s denominator. Quality-data codes are used to report the numerator of the measure. When reporting the measure via claims, submit the listed CPT codes, and the appropriate numerator quality-data code. All measure-specific coding should be reported on the claim(s) representing the eligible encounter. Measure Reporting via Registry: CPT codes and patient demographics are used to identify patients who are included in the measure s denominator. The listed numerator options are used to report the numerator of the measure. The quality-data codes listed do not need to be submitted for registry-based submissions; however, these codes may be submitted for those registries that utilize claims data. DENOMINATOR: All visits for patients aged 18 years and older Denominator Criteria (Eligible Cases): Patients aged 18 years on date of encounter AND Patient encounter during the reporting period (CPT): 97001, 97002, 97003, 97004, 98940, 98941, NUMERATOR: Patients with a documented current functional outcome assessment using a standardized tool AND a documented care plan based on the identified functional outcome deficiencies Numerator Instructions: Documentation of a current functional outcome assessment must include identification of the standardized tool used. Definitions: Standardized Tool A tool that has been normed and validated. Examples of tools for functional outcome assessment include, but are not limited to: Oswestry Disability Index (ODI), Roland Morris Disability/Activity Questionnaire (RM), Neck Disability Index (NDI), Patient-Reported Outcomes Measurement Information 11/17/2015 Page 1 of 11

2 System (PROMIS), Disabilities of the Arm, Shoulder and Hand (DASH), and Knee Outcome Survey Activities of Daily Living Scale (KOS-ADL). Note: A functional outcome assessment is multi-dimensional and quantifies pain and musculoskeletal/neuromusculoskeletal capacity; therefore the use of a standardized tool assessing pain alone, such as the visual analog scale (VAS), does not meet the criteria of a functional outcome assessment standardized tool. Functional Outcome Assessment Patient completed questionnaires designed to measure a patient's physical limitations in performing the usual human tasks of living and to directly quantify functional and behavioral symptoms. Current (Functional Outcome Assessment) A patient having a documented functional outcome assessment utilizing a standardized tool and a care plan if indicated within the previous 30 days. Functional Outcome Deficiencies Impairment or loss of physical function related to musculoskeletal/neuromusculoskeletal capacity, may include but are not limited to: restricted flexion, extension and rotation, back pain, neck pain, pain in the joints of the arms or legs, and headaches. Care Plan A care plan is an ordered assembly of expected/planned activities or actionable elements based on identified deficiencies. These may include observations goals, services, appointments and procedures, usually organized in phases or sessions, which have the objective of organizing and managing health care activity for the patient, often focused on one or more of the patient s health care problems. Care plans may also be known as a treatment plan. Not Eligible A patient is not eligible if one or more of the following reasons(s) is documented: Patient refuses to participate Patient unable to complete questionnaire Patient is in an urgent or emergent medical situation where time is of the essence and to delay treatment would jeopardize the patient s health status NUMERATOR NOTE: The intent of this measure is for a functional outcome assessment tool to be utilized at a minimum of every 30 days but reporting is required at each visit due to coding limitations. Therefore, for visits occurring within 30 days of a previously documented functional outcome assessment, the numerator quality-data code G8942 should be used for reporting purposes. Numerator Quality-Data Coding Options for Reporting Satisfactorily: Functional Outcome Assessment Documented as Positive AND Care Plan Documented (One quality-data code [G8539 or G8542 or G8942] is required on the claim form to submit this numerator option) Performance Met: G8539: Functional outcome assessment documented as positive using a standardized tool AND a care plan based, on identified deficiencies on the date of the functional outcome assessment, is documented OR Functional Outcome Assessment Documented, No Functional Deficiencies Identified, Care Plan not Required Performance Met: G8542: OR Functional outcome assessment using a standardized tool is documented; no functional deficiencies identified, care plan not required 11/17/2015 Page 2 of 11

3 OR OR Functional Outcome Assessment Documented AND Care Plan Documented, if Indicated, Within the Previous 30 Days Performance Met: G8942: Functional outcome assessment using a standardized tool is documented within the previous 30 days and care plan, based on identified deficiencies on the date of the functional outcome assessment, is documented Functional Outcome Assessment not Documented, Patient not Eligible (One quality-data code [G8540 or G9227] is required on the claim form to submit this numerator option) Other Performance Exclusion: G8540: Functional Outcome Assessment NOT documented as being performed, documentation the patient is not eligible for a functional outcome assessment using a standardized tool OR Functional Outcome Assessment Documented, Care Plan not Documented, Patient not Eligible Other Performance Exclusion: G9227: Functional outcome assessment documented, care plan not documented, documentation the patient is not eligible for a care plan Functional Outcome Assessment not Documented, Reason not Given (One quality-data code [G8541 or G8543] is required on the claim form to submit this numerator option) Performance Not Met: G8541: Functional outcome assessment using a standardized tool not documented, reason not given OR Functional Outcome Assessment Documented as Positive, Care Plan not Documented, Reason not Given Performance Not Met: G8543: Documentation of a positive functional outcome assessment using a standardized tool; care plan not documented, reason not given RATIONALE: Standardized outcome assessments, questionnaires or tools are a vital part of evidence-based practice. Despite the recognition of the importance of outcomes assessments, questionnaires and tools, recent evidence suggests their use in clinical practice is limited. Selecting the most appropriate outcomes assessment, questionnaire or tool enhances clinical practice by (1) identifying and quantifying body function and structure limitations; (2) formulating the evaluation, diagnosis, and prognosis; (3) informing the plan of care; and (4) helping to evaluate the success of physical therapy interventions (Potter et al., 2011). The use of standardized tests and measures early in an episode of care establishes the baseline status of the patient/client, providing a means to quantify change in the patient's/client's functioning. Outcome measures, along with other standardized tests and measures used throughout the episode of care, as part of periodic reexamination, provide information about whether predicted outcomes are being realized (American Physical Therapy Association (APTA), 2011). Early in the intervention process, occupational therapists should select outcomes that are valid, reliable, sensitive to change; congruent with client goals and based on their actual or purported ability to predict future outcomes. Outcomes are applied to measure progress and adjust goals and interventions. Results are used to make decisions about future direction of intervention (American Occupational Therapy Association (AOTA), 2014). Few outcome measures are routinely used to assess patients with neck pain other than a numeric pain rating scale. A comparison of practice patterns to current evidence suggests overutilization of some measures that have questionable reliability and underutilization of some with better supporting evidence. This practice analysis suggests that there is substantial need to implement more consistent outcome measurement (MacDermid et al., 2013). 11/17/2015 Page 3 of 11

4 Barriers to use of classification systems and outcome measures were lack of knowledge, too limiting and time. Classification systems are being used for decision-making in physical therapy practice for patients with lower back pain (LBP). Lack of knowledge and training seems to be the main barrier to the use of classification systems in practice. The Oswestry Disability Index and Numerical Pain Scale were the most commonly used outcome measures. The main barrier to their use was lack of time. Continuing education and reading the literature were identified as important tools to teach evidence-based practice to physical therapists in practice (Davies et al., 2014). Outcome use in occupational therapy indicated that some therapists used both biomechanical and self- assessment of function measures in their practice to measure outcomes, but the majority use biomechanical outcomes (Bohnen, 2011). Musculoskeletal disorders accounted for 6.8% of total Disability-adjusted life years (DALYs) as reported in the Global Burden of Disease Study 2010 (Hoy et al., 2014). Of this large total, low back pain accounted for nearly half, neck pain a fifth, and osteoarthritis about 10% (Murray, 2012). In 2010 the top 15 diseases and risk factors contributing to Disability-adjusted life years (DALYs) are a complex mix of cardiovascular diseases (ischemic heart disease and stroke), musculoskeletal disorder (low back pain, other musculoskeletal disorders, and neck pain), etc. (US Burden of Disease Collaborators, 2013). In 2010, there were 777 million Years lived with disability (YLDs) from all causes, up from 583 million in The main contributors to global YLDs were mental and behavioral disorders, musculoskeletal disorders and diabetes or endocrine disorders (Vos et al., 2012). In 2010 the top 8 conditions were the same in 1990 and 2010 for Years lived with disability (YLDs) in the United States: low back pain, major depressive disorder, other musculoskeletal disorders, neck pain, anxiety disorders and diabetes (US Burden of Disease Collaborators, 2013). One in two adults reports a musculoskeletal condition requiring medical attention. Annual direct and indirect costs for bone and joint health are 950 billion 7.4% of the gross domestic product. Musculoskeletal disorders and diseases are the leading cause of disability in the United States. Between and , the number of persons reporting a musculoskeletal disease increased nearly 14 million from 76 million reported in For the years the sum of the direct expenditures in health care costs and indirect expenditures in lost wages has been estimated to be $950 billion dollars annually, or 7.4% of the national gross domestic product (Bone and Joint Initiative USA, 2011). Musculoskeletal disorder (MSD) cases accounted for 33 percent of all injury and illness cases in Both the incidence rate and case count remained statistically unchanged from the previous year; however the median days away from work decreased by 1 day to a median of 11 days (Bureau of Labor and Statistics, 2014). Neck Pain is ranked as the 4th greatest contributor to global disability (Hoy et al., 2014). The annual prevalence of nonspecific neck pain is estimated to range between 30% and 50%. Persistent or recurrent neck pain continues to be reported by 50% to 85% of patients 1 to 5 years after initial onset. Its course is usually episodic, and complete recovery is uncommon for most patients. Twenty-seven percent of patients seeking chiropractic treatment report neck or cervical problems (Bryans et al., 2014). Neck disorders can cause pain and impairments in: joint motion, sensory function, proprioception, motor function, coordination, posture and balance. These can be associated with functional disability, loss of physical activity, loss of work capacity, psychological distress, and impaired quality of life (MacDermid et al., 2013). Low back pain is the leading cause of disability globally and was estimated to be responsible for 83 million years lived with a disability in 2010 (Buchbinder et al., 2013). The majority of individuals with an episode of acute low back pain improve and return to work within the first two weeks. The probability of recurrence within the first year ranges from 30 to 60%. Most of these recurrences will recover in much the same pattern as the initial event. In as many as one-third of the cases, the initial episode of low back pain persists for the next year. Most of these individuals continue to function with only limited impairment (ICSI, 2012). Low back pain symptoms peak between the ages of 40 and 69, are higher among females than males in all age groups, and are more common in affluent countries with high-income. Acute or chronic, LBP can lead to notable functional limitations and disability (Learman et al., 2014). 11/17/2015 Page 4 of 11

5 Most of the total cost for low back pain is dedicated to the small percentage of sufferers whose condition has progressed to the chronic disabling stage (pain for more than 12 weeks). The medical costs for low back pain in general were estimated at $26.3 billion in 1998 and now are one-third to one-fourth of the total cost of care. Lost production and disability account for other costs. Disability alone claims 80% of the total expense of this condition. Expenditures for medical care and disability continue to increase. The human cost is equally significant; low back pain is currently the second most common cause of disability in the United States and is the most common cause of disability in those under age 45 (Centers for Disease Control and Prevention, 2009) (ICSI, 2012). Visits to primary care clinicians for low back pain are equally split between chiropractors and allopathic clinicians, with low back pain the fifth most common reason for an office visit to all clinicians. The majority of these visits are not because of pain but rather due to the disability associated with the low back symptoms (ICSI, 2012). Arthritis is considered the leading cause of disability among adults in the United States today and contributes substantially to the rising cost of health care. According to recent results from the 2007 to 2009 National Health Interview Survey, just over 20% of adults have been physician diagnosed with arthritis, and this estimate is projected to reach 25% of adults, or 67 million by Affected most is the growing aging population that currently represents about 13% of the total US population, with this figure expected to increase over the next 2 decades to 19%, or 72 million persons. In rural (nonmetropolitan) areas, the elderly, approximately 15% of the rural population or 7.5 million persons, are especially affected, with evidence suggesting that these individuals experience higher rates of arthritis and comorbid conditions, poorer health status, greater poverty, and less access to medical care. Total attributable costs for arthritis in 2003 were US $128 billion, with direct costs estimated at $81 billion and indirect costs at $47 billion. In addition, arthritis accounted for 3% of all hospitalizations and 5% of all ambulatory care visits in 2004 related to a primary diagnosis of arthritis. Costs related to pharmaceutical use for arthritis were estimated at more than $75 billion in 2003 compared with $33 billion in 1997 (Enyinnaya et al., 2012). Osteoarthritis (OA) is the most frequently diagnosed form of arthritis among the elderly and contributes substantially to their associated disability (Enyinnaya et al., 2012). Knee OA affects 28% of adults older than 45 years and 37% of adults older than 65 years in the United States. Osteoarthritis is a leading cause of disability among noninstitutionalized adults (Wang et al., 2012). Average expense per episode of ambulatory physical therapy was $1184 with an average of 9.6 visits (Machlin et al., 2011). Physical activity limitations are associated with worse economic outcomes across multiple economic metrics (Dall et al., 2013). Inflation-adjusted biennial expenditures on ambulatory services for chronic back pain increased by 129% over the same period, from $15.6 billion in 2000 to 2001 to $35.7 billion in (Smith et al., 2013). Back pain and arthritis make their impact by sheer numbers in the population. Even if affected individual miss just a few days of work on average, or have their productivity slightly impaired, the cumulative results across the affected population can amount to tens of billions of dollars in lost wages and reduced work capacity each year. Conversely, interventions that make small improvements in the onset and progression of these chronically disabling diseases may result in significant overall health care cost savings (Ma et al., 2014). CLINICAL RECOMMENDATION STATEMENTS: As a category, functional outcome assessments of everyday tasks are very suitable for evaluating treatment of dysfunctions of the neuromusculoskeletal system. Many questionnaires could be used; choice should depend upon the validity, reliability, responsiveness, and practicality demonstrated in the scientific literature. Functional questionnaires seek to directly quantify symptoms, function and behavior, rather than draw inferences from relevant physiological tests. Clinicians contemplating the use of functional instruments should be aware of differences between questionnaires and choose the most appropriate assessment tool for the specific purpose (Haldeman et al., 2005) (Evidence Class: I, II, III, Consensus Level: 1). Utilization of validated pain and function scales help to differentiate treatment approaches in order to improve the patient's ability to function (ICSI, 2012). 11/17/2015 Page 5 of 11

6 Outcome measures/standardized assessments are used by physical therapists to evaluate patient response to therapeutic interventions. In a 2006 Centers for Medicare & Medicaid Services report, Uniform Patient Assessment for Post-Acute Care, the Division of Health Care Policy and Research recommended there is a role for uniform outcome assessments to determine long term function for patients leaving the acute care hospital. Clinicians should use validated functional outcome measures, such as the Disabilities of the Arm, Shoulder and Hand (DASH), the American Shoulder and Elbow Surgeons shoulder scale (ASES), or the Shoulder Pain and Disability Index (SPPADI). These should be utilized before and after interventions intended to alleviate the impairments of body function and structure, activity limitations, and participation restrictions associated with adhesive capsulitis (Kelley et al., 2013) (Guideline). Clinicians should use validated self-report questionnaires, such as the Oswestry Disability Index and the Roland- Morris Disability Questionnaire. These tools are useful for identifying a patient s baseline status relative to pain, function, and disability and for monitoring a change in a patient s status throughout the course of treatment (Delitto et al., 2012) (Guideline). The Oswestry Disability Questionnaire is used to assess the patient's subjective rating of perceived disability related to his or her functional limitations, e.g., work status, difficulty caring for oneself. The higher the score, the more perceived the disability. Using this test at the initial visit helps the examiner understand the patient's perception of how his or her back pain is affecting his or her life. There are two ways that this test aids in the treatment of back pain. A higher score is indicative of the need for more intensive treatment such as spinal manipulative therapy and education to help the patient understand the low likelihood of disability related to back pain. Understanding the low likelihood helps prevent the fear of disability from becoming a barrier to improvement. People with higher disability should be managed more aggressively, with a heightened sense of urgency to avoid the negative aspect of prolonged pain and disability. The use of anticipatory guidance and early return to work with appropriate restrictions are important aspects. By tracking these scores, improvement can be documented and monitored (Goertz et al., 2012) (Guideline). Tracking the outcomes of an implementation program is critical to evaluating its benefit to patients. (Kramer et al., 2013) Understanding the clinical course of a condition can help assessment of individual patient outcomes by providing a meaningful point of reference with which to compare an individual patient s progress (Leaver et al., 2013). The Council on Chiropractic Education (2012) recommended keeping appropriate records of the patient's evaluation and case management needs to aptly respond to changes in patient status, or failure of the patient to respond to care. The Institute of Medicine s (2012) Living Well with Chronic Illness: A Call for Public Health Action stated the surveillance systems need to be improved to assess health-related quality of life and functional status of patients. Federal and state governments should expand surveillance systems which can be used to inform the planning, development, implementation, and evaluation of public health policies, programs and interventions relevant to individuals with chronic illness. Outcome assessment scales provide a concise, valid way to track function and improvement in function. Anchored numerical scales are recommended for tracking routine progress, particularly pain interference with important activities. Regional or condition functional outcome scales should be routinely used at baseline and periodic followups. More frequent follow-up is recommended with higher frequency care (Washington State Department of Labor and Industries, 2014). COPYRIGHT: These measures were developed by Quality Insights of Pennsylvania as a special project under the Quality Insights' Medicare Quality Improvement Organization (QIO) contract HHSM PA001C with the Centers for Medicare & Medicaid Services. These measures are in the public domain. 11/17/2015 Page 6 of 11

7 Limited proprietary coding is contained in the measure specifications for convenience. Users of the proprietary code sets should obtain all necessary licenses from the owners of these code sets. Quality Insights of Pennsylvania disclaims all liability for use or accuracy of any Current Procedural Terminology (CPT [R]) or other coding contained in the specifications. CPT contained in the Measures specifications is copyright American Medical Association. All Rights Reserved. These performance measures are not clinical guidelines and do not establish a standard of medical care, and have not been tested for all potential applications. THE MEASURES AND SPECIFICATIONS ARE PROVIDED AS IS WITHOUT WARRANTY OF ANY KIND. 11/17/2015 Page 7 of 11

8 11/17/2015 Page 8 of 11

9 2016 Claims/Registry Individual Measure Flow PQRS #182 NQF# 2624: Functional Outcome Assessment Please refer to the specific section of the Measure Specification to identify the denominator and numerator information for use in reporting this Individual Measure. 1. Start with Denominator 2. Check Patient Age: a. If the Age is greater than or equal to 18 years of age at Date of Service and equals No during the measurement period, do not include in Eligible Patient Population. Stop Processing. b. If the Age is greater than or equal to 18 years of age at Date of Service and equals Yes during the measurement period, proceed to check Encounter Performed. 3. Check Encounter Performed: a. If Encounter as Listed in the Denominator equals No, do not include in Eligible Patient Population. Stop Processing. b. If Encounter as Listed in the Denominator equals Yes, include in the Eligible Population. 4. Denominator Population: a. Denominator population is all Eligible Patients in the denominator. Denominator is represented as Denominator in the Sample Calculation listed at the end of this document. Letter d equals 8 visits in the sample calculation. 5. Start Numerator 6. Check Functional Outcome Assessment Documented as Positive AND Care Plan Documented: a. If Functional Outcome Assessment Documented as Positive AND Care Plan Documented equals Yes, include in Reporting Met and Performance Met. b. Reporting Met and Performance Met letter is represented in the Reporting Rate and Performance Rate in the Sample Calculation listed at the end of this document. Letter a1 equals 1 visit in Sample c. If Functional Outcome Assessment Documented as Positive AND Care Plan Documented equals No, proceed to Functional Outcome Assessment Documented, No Functional Deficiencies Identified, Care Plan Not Required. 7. Check Functional Outcome Assessment Documented, No Functional Deficiencies Identified, Care Plan Not Required: a. If Functional Outcome Assessment Documented, No Functional Deficiencies Identified, Care Plan Not Required equals Yes, include in Reporting Met and Performance Met. b. Reporting Met and Performance Met letter is represented in the Reporting Rate and Performance Rate in the Sample Calculation listed at the end of this document. Letter a2 equals 3 visits in the Sample 11/17/2015 Page 9 of 11

10 c. If Functional Outcome Assessment Documented, No Functional Deficiencies Identified, Care Plan Not Required equals No, proceed to Functional Outcome Assessment Documented AND Care Plan Documented, if Indicated within Previous 30 Days. 8. Check Functional Outcome Assessment Documented AND Care Plan Documented, if Indicated within Previous 30 Days: a. If Functional Outcome Assessment Documented AND Care Plan Documented, if Indicated within Previous 30 Days equals Yes, include in the Reporting Met and Performance Met. b. Reporting Met and Performance Met letter is represented in the Reporting Rate and Performance Rate in the Sample Calculation listed at the end of this document. Letter a3 equals 0 visits in the Sample c. If Functional Outcome Assessment Documented AND Care Plan Documented, if Indicated within Previous 30 Days equals No, proceed to Functional Outcome Assessment Not Documented, Patient Not Eligible. 9. Check Functional Outcome Assessment Not Documented, Patient Not Eligible: a. If Functional Outcome Assessment Not Documented, Patient Not Eligible equals Yes, include in Reporting Met and Performance Exclusion. b. Reporting Met and Performance Exclusion letter is represented in the Reporting Rate and Performance Rate in the Sample Calculation listed at the end of this document. Letter b1 equals 1 visit in the Sample c. If Functional Outcome Assessment Not Documented, Patient Not Eligible equals No, proceed to Functional Outcome Assessment Documented, Care Plan Not Documented, Patient Not Eligible. 10. Check Functional Outcome Assessment Documented, Care Plan Not Documented, Patient Not Eligible: a. If Functional Outcome Assessment Documented, Care Plan Not Documented, Patient Not Eligible equals Yes, include in Reporting Met and Performance Exclusion. b. Reporting Met and Performance Exclusion letter is represented in the Reporting Rate and Performance Rate in the Sample Calculation listed at the end of this document. Letter b2 equals 0 visits in the Sample c. If Functional Outcome Assessment Documented, Care Plan Not Documented, Patient Not Eligible equals No, proceed to Functional Outcome Assessment Not Documented, Reason Not Given. 11. Check Functional Outcome Assessment Not Documented, Reason Not Given: a. If Functional Outcome Assessment Not Documented, Reason Not Given equals Yes, include in Reporting Met and Performance Not Met. b. Reporting Met and Performance Not Met letter is represented in the Reporting Rate and Performance Rate in the Sample Calculation listed at the end of this document. Letter c1 equals 0 visits in the Sample c. If Functional Outcome Assessment Not Documented, Reason Not Given equals No, proceed to Functional Outcome Assessment Documented as Positive, Care Plan Not Documented, Reason Not Given. 11/17/2015 Page 10 of 11

11 12. Check Functional Outcome Assessment Documented as Positive, Care Plan Not Documented, Reason Not Given: a. If Functional Outcome Assessment Documented as Positive, Care Plan Not Documented, Reason Not Given equals Yes, include in Reporting Met and Performance Not Met. b. Reporting Met and Performance Not Met letter is represented in the Reporting Rate and Performance Rate in the Sample Calculation listed at the end of this document. Letter c2 equals 2 visits in the Sample c. If Functional Outcome Assessment Documented as Positive, Care Plan Not Documented, Reason Not Given equals No, proceed to Reporting Not Met. 13. Check Reporting Not Met: a. If Reporting Not Met equals No, Quality Data Code or equivalent not reported. 1 visit has been subtracted from the reporting numerator in the sample calculation. 11/17/2015 Page 11 of 11

2016 PQRS OPTIONS FOR INDIVIDUAL MEASURES: CLAIMS, REGISTRY

2016 PQRS OPTIONS FOR INDIVIDUAL MEASURES: CLAIMS, REGISTRY Measure #128 (NQF 0421): Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan National Quality Strategy Domain: Community/Population Health 2016 PQRS OPTIONS F INDIVIDUAL MEASURES:

More information

NO RECORDING OF ANY TYPE ALLOWED. Unauthorized Audiotaping or Videotaping or Distribution of any presentation materials is illegal.

NO RECORDING OF ANY TYPE ALLOWED. Unauthorized Audiotaping or Videotaping or Distribution of any presentation materials is illegal. Medicare PQRS Coding With Mario Fucinari DC, MCS-P, MCS-I Certified Insurance Consultant Certified Medical Compliance Specialist (MCS-P) Sponsored by Foot Levelers The information contained in these notes

More information

2016 PQRS OPTIONS FOR INDIVIDUAL MEASURES: CLAIMS, REGISTRY

2016 PQRS OPTIONS FOR INDIVIDUAL MEASURES: CLAIMS, REGISTRY Measure #317: Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented National Quality Strategy Domain: Community / Population Health 2016 PQRS OPTIONS F INDIVIDUAL MEASURES:

More information

2016 PQRS OPTIONS FOR INDIVIDUAL MEASURES: REGISTRY ONLY

2016 PQRS OPTIONS FOR INDIVIDUAL MEASURES: REGISTRY ONLY Measure #218 (NQF 0423): Functional Deficit: Change in Risk-Adjusted Functional Status for Patients with Hip Impairments National Quality Strategy Domain: Communication and Care Coordination 2016 PQRS

More information

2016 PQRS OPTIONS FOR INDIVIDUAL MEASURES: CLAIMS, REGISTRY

2016 PQRS OPTIONS FOR INDIVIDUAL MEASURES: CLAIMS, REGISTRY Measure #226 (NQF 0028): Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention National Quality Strategy Domain: Community / Population Health 2016 PQRS OPTIONS FOR INDIVIDUAL

More information

Measure #130 (NQF 0419): Documentation of Current Medications in the Medical Record National Quality Strategy Domain: Patient Safety

Measure #130 (NQF 0419): Documentation of Current Medications in the Medical Record National Quality Strategy Domain: Patient Safety Measure #130 (NQF 0419): Documentation of Current Medications in the Medical Record National Quality Strategy Domain: Patient Safety 2016 PQRS OPTIONS FOR INDIVIDUAL MEASURES: CLAIMS, REGISTRY DESCRIPTION:

More information

2016 PQRS OPTIONS FOR INDIVIDUAL MEASURES: REGISTRY ONLY

2016 PQRS OPTIONS FOR INDIVIDUAL MEASURES: REGISTRY ONLY Measure #143 (NQF 0384): Oncology: Medical and Radiation Pain Intensity Quantified National Quality Strategy Domain: Person and Caregiver-Centered Experience and Outcomes 2016 PQRS OPTIONS FOR INDIVIDUAL

More information

Measure #46 (NQF 0097): Medication Reconciliation Post-Discharge National Quality Strategy Domain: Communication and Care Coordination

Measure #46 (NQF 0097): Medication Reconciliation Post-Discharge National Quality Strategy Domain: Communication and Care Coordination Measure #46 (NQF 0097): Medication Reconciliation Post-Discharge National Quality Strategy Domain: Communication and Care Coordination 2016 PQRS OPTIONS FOR INDIVIDUAL MEASURES: CLAIMS, REGISTRY DESCRIPTION:

More information

PQRS Claims Measures Details- Quick Reference 2014

PQRS Claims Measures Details- Quick Reference 2014 Measure Preventive Care and Screening: Body Mass Index (BMI) Screening and #128 Follow-up Medicare patients 18+ years of age, screened for BMI Normal: Age 65 years and older BMI > 23 and < 30 Age 18 to

More information

Measure #39 (NQF 0046): Screening for Osteoporosis for Women Aged 65-85 Years of Age National Quality Strategy Domain: Effective Clinical Care

Measure #39 (NQF 0046): Screening for Osteoporosis for Women Aged 65-85 Years of Age National Quality Strategy Domain: Effective Clinical Care Measure #39 (NQF 0046): Screening for Osteoporosis for Women Aged 65-85 Years of Age National Quality Strategy Domain: Effective Clinical Care 2016 PQRS OPTIONS FOR INDIVIDUAL MEASURES: CLAIMS, REGISTRY

More information

DENOMINATOR: All female patients aged 65 years and older with a diagnosis of urinary incontinence

DENOMINATOR: All female patients aged 65 years and older with a diagnosis of urinary incontinence Measure #50: Urinary Incontinence: Plan of Care for Urinary Incontinence in Women Aged 65 Years and Older National Quality Strategy Domain: Person and Caregiver-Centered Experience and Outcomes 2016 PQRS

More information

Normal Parameters: Age 65 years and older BMI 23 and < 30 kg/m 2 Age 18 64 years BMI 18.5 and < 25 kg/m 2

Normal Parameters: Age 65 years and older BMI 23 and < 30 kg/m 2 Age 18 64 years BMI 18.5 and < 25 kg/m 2 Measure #128 (NQF 0421): Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan National Quality Strategy Domain: Community/Population Health 2015 PQRS OPTIONS F INDIVIDUAL MEASURES:

More information

Measure #406: Appropriate Follow-up Imaging for Incidental Thyroid Nodules in Patients National Quality Strategy Domain: Effective Clinical Care

Measure #406: Appropriate Follow-up Imaging for Incidental Thyroid Nodules in Patients National Quality Strategy Domain: Effective Clinical Care Measure #406: Appropriate Follow-up Imaging for Incidental Thyroid Nodules in Patients National Quality Strategy Domain: Effective Clinical Care 2016 PQRS OPTIONS FOR INDIVIDUAL MEASURES: CLAIMS, REGISTRY

More information

Measure #112 (NQF 2372): Breast Cancer Screening National Quality Strategy Domain: Effective Clinical Care

Measure #112 (NQF 2372): Breast Cancer Screening National Quality Strategy Domain: Effective Clinical Care Measure #112 (NQF 2372): Breast Cancer Screening National Quality Strategy Domain: Effective Clinical Care 2016 PQRS OPTIONS FOR INDIVIDUAL MEASURES: CLAIMS, REGISTRY DESCRIPTION: Percentage of women 50

More information

Measure #370 (NQF 0710): Depression Remission at Twelve Months National Quality Strategy Domain: Effective Clinical Care

Measure #370 (NQF 0710): Depression Remission at Twelve Months National Quality Strategy Domain: Effective Clinical Care Measure #370 (NQF 0710): Depression Remission at Twelve Months National Quality Strategy Domain: Effective Clinical Care 2016 PQRS OPTIONS F INDIVIDUAL MEASURES: REGISTRY ONLY DESCRIPTION: Adult patients

More information

Measure #12 (NQF 0086): Primary Open-Angle Glaucoma (POAG): Optic Nerve Evaluation National Quality Strategy Domain: Effective Clinical Care

Measure #12 (NQF 0086): Primary Open-Angle Glaucoma (POAG): Optic Nerve Evaluation National Quality Strategy Domain: Effective Clinical Care Measure #12 (NQF 0086): Primary Open-Angle Glaucoma (POAG): Optic Nerve Evaluation National Quality Strategy Domain: Effective Clinical Care 2016 PQRS OPTIONS FOR INDIVIDUAL MEASURES: CLAIMS, REGISTRY

More information

Measure #420: Varicose Vein Treatment with Saphenous Ablation: Outcome Survey National Quality Strategy Domain: Effective Clinical Care

Measure #420: Varicose Vein Treatment with Saphenous Ablation: Outcome Survey National Quality Strategy Domain: Effective Clinical Care Measure #420: Varicose Vein Treatment with Saphenous Ablation: Outcome Survey National Quality Strategy Domain: Effective Clinical Care 2016 PQRS OPTIONS FOR INDIVIDUAL MEASURES: REGISTRY ONLY DESCRIPTION:

More information

2016 PQRS OPTIONS FOR INDIVIDUAL MEASURES: CLAIMS, REGISTRY

2016 PQRS OPTIONS FOR INDIVIDUAL MEASURES: CLAIMS, REGISTRY Measure #326 (NQF 1525): Atrial Fibrillation and Atrial Flutter: Chronic Anticoagulation Therapy National Quality Strategy Domain: Effective Clinical Care 2016 PQRS OPTIONS FOR INDIVIDUAL MEASURES: CLAIMS,

More information

Measure #236 (NQF 0018): Controlling High Blood Pressure National Quality Strategy Domain: Effective Clinical Care

Measure #236 (NQF 0018): Controlling High Blood Pressure National Quality Strategy Domain: Effective Clinical Care Measure #236 (NQF 0018): Controlling High Blood Pressure National Quality Strategy Domain: Effective Clinical Care 2016 PQRS OPTIONS F INDIVIDUAL MEASURES: CLAIMS, REGISTRY DESCRIPTION: Percentage of patients

More information

Measure #195 (NQF 0507): Radiology: Stenosis Measurement in Carotid Imaging Reports National Quality Strategy Domain: Effective Clinical Care

Measure #195 (NQF 0507): Radiology: Stenosis Measurement in Carotid Imaging Reports National Quality Strategy Domain: Effective Clinical Care Measure #195 (NQF 0507): Radiology: Stenosis Measurement in Carotid Imaging Reports National Quality Strategy Domain: Effective Clinical Care 2016 PQRS OPTIONS FOR INDIVIDUAL MEASURES: CLAIMS, REGISTRY

More information

2016 PQRS OPTIONS FOR INDIVIDUAL MEASURES: REGISTRY ONLY

2016 PQRS OPTIONS FOR INDIVIDUAL MEASURES: REGISTRY ONLY Measure #426: Post-Anesthetic Transfer of Care Measure: Procedure Room to a Post Anesthesia Care Unit (PACU) National Quality Strategy Domain: Communication and Care Coordination 2016 PQRS OPTIONS FOR

More information

Measure #41: Osteoporosis: Pharmacologic Therapy for Men and Women Aged 50 Years and Older National Quality Strategy Domain: Effective Clinical Care

Measure #41: Osteoporosis: Pharmacologic Therapy for Men and Women Aged 50 Years and Older National Quality Strategy Domain: Effective Clinical Care Measure #41: Osteoporosis: Pharmacologic Therapy for Men and Women Aged 50 Years and Older National Quality Strategy Domain: Effective Clinical Care 2016 PQRS OPTIONS FOR INDIVIDUAL MEASURES: CLAIMS, REGISTRY

More information

Measure #405: Appropriate Follow-up Imaging for Incidental Abdominal Lesions National Quality Strategy Domain: Effective Clinical Care

Measure #405: Appropriate Follow-up Imaging for Incidental Abdominal Lesions National Quality Strategy Domain: Effective Clinical Care Measure #405: Appropriate Follow-up Imaging for Incidental Abdominal Lesions National Quality Strategy Domain: Effective Clinical Care 2016 PQRS OPTIONS FOR INDIVIDUAL MEASURES: CLAIMS, REGISTRY DESCRIPTION:

More information

A Guidebook to the 2015 Physician Quality Reporting System

A Guidebook to the 2015 Physician Quality Reporting System A Guidebook to the 2015 Physician Quality Reporting System Last Updated: December 22, 2014 What is PQRS? The Physician Quality Reporting System (PQRS), formally known as the Physician Quality Reporting

More information

BACK PAIN MEASURES GROUP OVERVIEW

BACK PAIN MEASURES GROUP OVERVIEW 2014 PQRS OPTIONS F MEASURES GROUPS: BACK PAIN MEASURES GROUP OVERVIEW 2014 PQRS MEASURES IN BACK PAIN MEASURES GROUP: #148. Back Pain: Initial Visit #149. Back Pain: Physical Exam #150. Back Pain: Advice

More information

Measure #420: Varicose Vein Treatment with Saphenous Ablation: Outcome Survey National Quality Strategy Domain: Effective Clinical Care

Measure #420: Varicose Vein Treatment with Saphenous Ablation: Outcome Survey National Quality Strategy Domain: Effective Clinical Care Measure #420: Varicose Vein Treatment with Saphenous Ablation: Outcome Survey National Quality Strategy Domain: Effective Clinical Care 2017 OPTIONS FOR INDIVIDUAL MEASURES: REGISTRY ONLY MEASURE TYPE:

More information

Measure #145: Radiology: Exposure Time Reported for Procedures Using Fluoroscopy National Quality Strategy Domain: Patient Safety

Measure #145: Radiology: Exposure Time Reported for Procedures Using Fluoroscopy National Quality Strategy Domain: Patient Safety Measure #145: Radiology: Exposure Time Reported for Procedures Using Fluoroscopy National Quality Strategy Domain: Patient Safety 2016 PQRS OPTIONS FOR INDIVIDUAL MEASURES: CLAIMS, REGISTRY DESCRIPTION:

More information

CPT only copyright 2014 American Medical Association. All rights reserved. 10/10/2014 Page 537 of 593

CPT only copyright 2014 American Medical Association. All rights reserved. 10/10/2014 Page 537 of 593 Measure #391 (NQF 0576): Follow-Up After Hospitalization for Mental Illness (FUH) National Quality Strategy Domain: Communication and Care Coordination 2015 PHYSICIAN QUALITY REPTING OPTIONS F INDIVIDUAL

More information

Using Outcome Measures in the Clinic

Using Outcome Measures in the Clinic Using Outcome Measures in the Clinic Jennifer Harwood BscPT, FCAMPT and Andrew White BPE, BScPT, FCAMPT Outcome measures are a way for clinicians to measure clinical change in patients over time. There

More information

Optum Physical Health. Clinical Forms Instruction Manual

Optum Physical Health. Clinical Forms Instruction Manual Optum Physical Health Clinical Forms Instruction Manual OptumHealth Care Solutions Physical Health includes OptumHealth Care Solutions, Inc., ACN Group IPA of New York, Inc., Managed Physical Network,

More information

16. ARTHRITIS, OSTEOPOROSIS, AND CHRONIC BACK CONDITIONS

16. ARTHRITIS, OSTEOPOROSIS, AND CHRONIC BACK CONDITIONS 16. ARTHRITIS, OSTEOPOROSIS, AND CHRONIC BACK CONDITIONS Goal Reduce the impact of several major musculoskeletal conditions by reducing the occurrence, impairment, functional limitations, and limitation

More information

2016 PQRS OPTIONS FOR INDIVIDUAL MEASURES: REGISTRY ONLY

2016 PQRS OPTIONS FOR INDIVIDUAL MEASURES: REGISTRY ONLY Measure #5 (NQF 0081): Heart Failure (HF): Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy for Left Ventricular Systolic Dysfunction (LVSD) National Quality

More information

MOLINA HEALTHCARE OF CALIFORNIA

MOLINA HEALTHCARE OF CALIFORNIA MOLINA HEALTHCARE OF CALIFORNIA MAJOR DEPRESSION IN ADULTS IN PRIMARY CARE HEALTH CARE GUIDELINE (ICSI) Health Care Guideline Twelfth Edition May 2009. The guideline was reviewed and adopted by the Molina

More information

Guidelines for Medical Necessity Determination for Occupational Therapy

Guidelines for Medical Necessity Determination for Occupational Therapy Guidelines for Medical Necessity Determination for Occupational Therapy These Guidelines for Medical Necessity Determination (Guidelines) identify the clinical information MassHealth needs to determine

More information

Treatment Plans An Opportunity S.O.A.P. Assessment Visit/Treatment Visit Paradigm

Treatment Plans An Opportunity S.O.A.P. Assessment Visit/Treatment Visit Paradigm Treatment Plans An Opportunity On Friday, July 19, published proposed changes to the 2014 Physician Fee Schedule. They included a request for comments on chiropractors being paid for E/M codes. In other

More information

New Functional Limitation Reporting Requirements Under Medicare Part B

New Functional Limitation Reporting Requirements Under Medicare Part B New Functional Limitation Reporting Requirements Under Medicare Part B Heather Smith, PT, MPH 1 BACKGROUND AND OVERVIEW 2 1 History of Medicare Therapy Caps and Reform Payment in Therapy Services 2013

More information

BACKGROUND. ADA and the European Association recently issued a consensus algorithm for management of type 2 diabetes

BACKGROUND. ADA and the European Association recently issued a consensus algorithm for management of type 2 diabetes BACKGROUND More than 25% of people with diabetes take insulin ADA and the European Association recently issued a consensus algorithm for management of type 2 diabetes Insulin identified as the most effective

More information

Introduction. Overview. 1 Musculo-Skeletal Conditions In New Zealand The Crippling Burden. 42% Neck. 30% Shoulder(s) 11% Upper Back.

Introduction. Overview. 1 Musculo-Skeletal Conditions In New Zealand The Crippling Burden. 42% Neck. 30% Shoulder(s) 11% Upper Back. Introduction This publication quantifies the burden of musculoskeletal disorders in New Zealand. It aims to demonstrate the huge financial and social impacts of this group of disorders and through this

More information

Measure #430: Prevention of Post-Operative Nausea and Vomiting (PONV) Combination Therapy National Quality Strategy Domain: Patient Safety

Measure #430: Prevention of Post-Operative Nausea and Vomiting (PONV) Combination Therapy National Quality Strategy Domain: Patient Safety Measure #430: Prevention of Post-Operative Nausea and Vomiting (PONV) Combination Therapy National Quality Strategy Domain: Patient Safety 2016 PQRS OPTIONS FOR INDIVIDUAL MEASURES: REGISTRY ONLY DESCRIPTION:

More information

CPT Coding Update And Other Issues

CPT Coding Update And Other Issues CPT Coding Update And Other Issues Robert E. Smith, M.D. Alison Lynch, M.D. November 13, 2013 1 Disclaimer This information is for educational and informational purposes only, and represents the understanding

More information

International Postprofessional Doctoral of Physical Therapy (DPT) in Musculoskeletal Management Program (non US/Canada) Curriculum

International Postprofessional Doctoral of Physical Therapy (DPT) in Musculoskeletal Management Program (non US/Canada) Curriculum International Postprofessional Doctoral of Physical Therapy (DPT) in Musculoskeletal Management Program (non US/Canada) Curriculum Effective: July 2015 INTERNATIONAL POSTPROFESSIONAL DOCTORAL OF PHYSICAL

More information

Back & Neck Pain Survival Guide

Back & Neck Pain Survival Guide Back & Neck Pain Survival Guide www.kleinpeterpt.com Zachary - 225-658-7751 Baton Rouge - 225-768-7676 Kleinpeter Physical Therapy - Spine Care Program Finally! A Proven Assessment & Treatment Program

More information

A Guidebook to the 2012 Physician Quality Reporting System

A Guidebook to the 2012 Physician Quality Reporting System A Guidebook to the 2012 Physician Quality Reporting System Last Updated: February 2, 2012 Getting Started With PQRS The Patient Protection and Affordable Care Act made participation in Medicare s Physician

More information

DENOMINATOR: All patients aged 18 years and older with a diagnosis of chronic hepatitis C cirrhosis

DENOMINATOR: All patients aged 18 years and older with a diagnosis of chronic hepatitis C cirrhosis Measure #401: Hepatitis C: Screening for Hepatocellular Carcinoma (HCC) in Patients with Cirrhosis National Quality Strategy Domain: Effective Clinical Care 2016 PQRS OPTIONS FOR INDIVIDUAL MEASURES: REGISTRY

More information

HEALTH CARE COSTS 11

HEALTH CARE COSTS 11 2 Health Care Costs Chronic health problems account for a substantial part of health care costs. Annually, three diseases, cardiovascular disease (including stroke), cancer, and diabetes, make up about

More information

Spine Vol. 30 No. 16; August 15, 2005, pp 1799-1807

Spine Vol. 30 No. 16; August 15, 2005, pp 1799-1807 A Randomized Controlled Trial of an Educational Intervention to Prevent the Chronic Pain of Whiplash Associated Disorders Following Rear-End Motor Vehicle Collisions 1 Spine Vol. 30 No. 16; August 15,

More information

Effect of mental health on long-term recovery following a Road Traffic Crash: Results from UQ SuPPORT study

Effect of mental health on long-term recovery following a Road Traffic Crash: Results from UQ SuPPORT study 1 Effect of mental health on long-term recovery following a Road Traffic Crash: Results from UQ SuPPORT study ACHRF 19 th November, Melbourne Justin Kenardy, Michelle Heron-Delaney, Jacelle Warren, Erin

More information

DENOMINATOR: The total number of adult patients (age 18 and over) having had non-emergency surgery

DENOMINATOR: The total number of adult patients (age 18 and over) having had non-emergency surgery Measure #358: Patient-centered Surgical Risk Assessment and Communication National Quality Strategy Domain: Person and Caregiver-Centered Experience and Outcomes 2016 PQRS OPTIONS FOR INDIVIDUAL MEASURES:

More information

First Year. PT7040- Clinical Skills and Examination II

First Year. PT7040- Clinical Skills and Examination II First Year Summer PT7010 Anatomical Dissection for Physical Therapists This is a dissection-based, radiographic anatomical study of the spine, lower extremity, and upper extremity as related to physical

More information

Manual Physical Therapy Certificate Program. Curriculum

Manual Physical Therapy Certificate Program. Curriculum Manual Physical Therapy Certificate Program Curriculum Effective: January 2014 MANUAL PHYSICAL THERAPY CERTIFICATE PROGRAM Program Director: Dr. Robert Boyles The EIM Manual Therapy Certificate Program

More information

Measure #1 (NQF 0059): Diabetes: Hemoglobin A1c Poor Control National Quality Strategy Domain: Effective Clinical Care

Measure #1 (NQF 0059): Diabetes: Hemoglobin A1c Poor Control National Quality Strategy Domain: Effective Clinical Care Measure #1 (NQF 0059): Diabetes: Hemoglobin A1c Poor Control National Quality Strategy Domain: Effective Clinical Care 2016 PQRS OPTIONS FOR INDIVIDUAL MEASURES: CLAIMS, REGISTRY DESCRIPTION: Percentage

More information

2016 Physician Quality Reporting System (PQRS) Measure Specification and Measure Flow Guide for Claims and Registry Reporting of Individual Measures

2016 Physician Quality Reporting System (PQRS) Measure Specification and Measure Flow Guide for Claims and Registry Reporting of Individual Measures 2016 Physician Quality Reporting System (PQRS) Measure Specification and Measure Flow Guide for Claims and Registry Reporting of Individual Measures Utilized by Individual Eligible Professionals for Claims

More information

Treating Depression to Remission in the Primary Care Setting. James M. Slayton, M.D., M.B.A. Medical Director United Behavioral Health

Treating Depression to Remission in the Primary Care Setting. James M. Slayton, M.D., M.B.A. Medical Director United Behavioral Health Treating Depression to Remission in the Primary Care Setting James M. Slayton, M.D., M.B.A. Medical Director United Behavioral Health 2007 United Behavioral Health 1 2007 United Behavioral Health Goals

More information

SUBMISSION TO THE MEDICARE BENEFITS SCHEDULE REVIEW TASKFORCE

SUBMISSION TO THE MEDICARE BENEFITS SCHEDULE REVIEW TASKFORCE SUBMISSION November 2015 SUBMISSION TO THE MEDICARE BENEFITS SCHEDULE REVIEW TASKFORCE Submission by the Chiropractors Association of Australia Page 1 of 10 About the Chiropractors Association of Australia

More information

2016 PQRS OPTIONS FOR INDIVIDUAL MEASURES: REGISTRY ONLY

2016 PQRS OPTIONS FOR INDIVIDUAL MEASURES: REGISTRY ONLY Measure #337: Tuberculosis Prevention for Psoriasis,Psoriatic Arthritis and Rheumatoid Arthritis Patients on a Biological Immune Response Modifier National Quality Strategy Domain: Effective Clincal Care

More information

2013 PQRS Measures Groups Specifications Manual BACK PAIN MEASURES GROUP OVERVIEW

2013 PQRS Measures Groups Specifications Manual BACK PAIN MEASURES GROUP OVERVIEW 2013 PQRS OPTIONS F MEASURES GROUPS: CLAIMS, REGISTRY BACK PAIN MEASURES GROUP OVERVIEW 2013 PQRS MEASURES IN BACK PAIN MEASURES GROUP: #148. Back Pain: Initial Visit #149. Back Pain: Physical Exam #150.

More information

Health Indicators. Issue 2-September 2011

Health Indicators. Issue 2-September 2011 Health Indicators Issue 2-September 2011 This is the second in a series of information bulletins published by the Office of the Chief Medical Officer of Health on population health indicators in New Brunswick.

More information

Overview Medication Adherence Where Are We Today?

Overview Medication Adherence Where Are We Today? Overview Medication Adherence Where Are We Today? This section covers the following topics: Adherence concepts and terminology Statistics related to adherence Consequences of medication nonadherence Factors

More information

McKenzie Method. Physical Therapy Treatment for lower back pain by Amy Romano

McKenzie Method. Physical Therapy Treatment for lower back pain by Amy Romano McKenzie Method Physical Therapy Treatment for lower back pain by Amy Romano What is the McKenzie Method? The McKenzie method (also known as MDT = Mechanical Diagnosis and Therapy) is a comprehensive method

More information

OCAN Comments Suggested Amendments to SFC Chronic Care Working Group Policy Options Paper

OCAN Comments Suggested Amendments to SFC Chronic Care Working Group Policy Options Paper OCAN Comments Suggested Amendments to SFC Chronic Care Working Group Policy Options Paper The Obesity Care Advocacy Network (OCAN) is pleased to provide the following comments in response to the Senate

More information

Resource Guide. Antidepressant Medication Management. A helpful resource for primary care physicians

Resource Guide. Antidepressant Medication Management. A helpful resource for primary care physicians Resource Guide Antidepressant Medication Management A helpful resource for primary care physicians August 2015 Depression Management Managing your patients with depression This booklet provides an overview

More information

Cancellation/No Show Policy

Cancellation/No Show Policy Cancellation/No Show Policy If you are unable to keep your scheduled appointment we require a 24 hour advance notice. Failure to provide this notice will result in a $50.00 cancellation/no show fee. You

More information

Measure #66 (NQF 0002): Appropriate Testing for Children with Pharyngitis National Quality Strategy Domain: Efficiency and Cost Reduction

Measure #66 (NQF 0002): Appropriate Testing for Children with Pharyngitis National Quality Strategy Domain: Efficiency and Cost Reduction Measure #66 (NQF 0002): Appropriate Testing for Children with Pharyngitis National Quality Strategy Domain: Efficiency and Cost Reduction 2016 PQRS OPTIONS FOR INDIVIDUAL MEASURES: REGISTRY ONLY DESCRIPTION:

More information

The Burden of Pain Among Adults in the United States

The Burden of Pain Among Adults in the United States P F I Z E R F A C T S The Burden of Pain Among Adults in the United States Findings from the National Health and Nutrition Examination Survey, the National Health Care Surveys, and the National Health

More information

RE: CMS-3819-P; Medicare and Medicaid Programs; Conditions of Participation for Home Health Agencies

RE: CMS-3819-P; Medicare and Medicaid Programs; Conditions of Participation for Home Health Agencies January 6, 2015 Marilyn Tavenner Administrator Centers for Medicare & Medicaid Services Department of Health and Human Services Room 445 G Attention: CMS-3819-P Hubert H. Humphrey Building, 200 Independence

More information

Responses progress from no impairment to severely impaired. Consider the degree of impairment.

Responses progress from no impairment to severely impaired. Consider the degree of impairment. (M1700) Cognitive Functioning: Patient's current (day of assessment) level of alertness, orientation, comprehension, concentration, and immediate memory for simple commands. 0 - Alert/oriented, able to

More information

6/3/2011. High Prevalence and Incidence. Low back pain is 5 th most common reason for all physician office visits in the U.S.

6/3/2011. High Prevalence and Incidence. Low back pain is 5 th most common reason for all physician office visits in the U.S. High Prevalence and Incidence Prevalence 85% of Americans will experience low back pain at some time in their life. Incidence 5% annual Timothy C. Shen, M.D. Physical Medicine and Rehabilitation Sub-specialty

More information

MN Community Measurement Low Back Pain Measure Impact and Recommendation Document June 2010

MN Community Measurement Low Back Pain Measure Impact and Recommendation Document June 2010 MN Community Measurement Low Back Pain Measure Impact and Recommendation Document June 2010 Impact Relevance to Consumers, Employers and Payers Improvability Inclusiveness Mechanical low back pain (LBP)

More information

University of Evansville Doctor of Physical Therapy Program

University of Evansville Doctor of Physical Therapy Program Year 1 Summer University of Evansville Doctor of Physical Therapy Program PT 441 Clinical & Professional Issues I: Introduction First in series of clinical and professional issues courses. Provides introduction

More information

FAMILY CARERS AND THE PHYSICAL IMPACT OF CARING INJURY AND PREVENTION

FAMILY CARERS AND THE PHYSICAL IMPACT OF CARING INJURY AND PREVENTION FAMILY CARERS AND THE PHYSICAL IMPACT OF CARING INJURY AND PREVENTION EXECUTIVE SUMMARY Introduction A family carer is defined as someone who provides care and support for a family member, friend or neighbour

More information

THE MEDICAL TREATMENT GUIDELINES

THE MEDICAL TREATMENT GUIDELINES THE MEDICAL TREATMENT GUIDELINES I. INTRODUCTION A. About the Medical Treatment Guidelines. On December 1, 2010, the NYS Workers' Compensation Board is implementing new regulations and Medical Treatment

More information

Clinical Medical Policy Outpatient Rehab Therapies (PT & OT) for Members With Special Needs

Clinical Medical Policy Outpatient Rehab Therapies (PT & OT) for Members With Special Needs Benefit Coverage Rehabilitative services, (PT, OT,) are covered for members with neurodevelopmental disorders when recommended by a medical provider to address a specific condition, deficit, or dysfunction,

More information

February 26, 2016. Dear Mr. Slavitt:

February 26, 2016. Dear Mr. Slavitt: February 26, 2016 Mr. Andy Slavitt Acting Administrator Centers for Medicare & Medicaid Services (CMS) Department of Health and Human Services Attention: CMS-3321-NC PO Box 8016 Baltimore, MD 21244 Re:

More information

Musculoskeletal Disorders

Musculoskeletal Disorders www.dal.ca Musculoskeletal Disorders Dr Anil Adisesh JD Irving, Limited Research Chair in Occupational Medicine What is a musculoskeletal disorder? Musculoskeletal system two components the muscular system

More information

Alzheimer s Impact on the American People and the Economy

Alzheimer s Impact on the American People and the Economy www.alz.org Public Policy Office 202 393 7737 p 1212 New York Avenue, NW 866 865 0270 f Suite 800 Washington, DC 20005-6105 Testimony of Harry Johns, President and CEO of the Alzheimer s Association Fiscal

More information

TRADIES NATIONAL HEALTH MONTH HEALTH SNAPSHOT

TRADIES NATIONAL HEALTH MONTH HEALTH SNAPSHOT TRADIES NATIONAL HEALTH month AUGUST 2016 TRADIES NATIONAL HEALTH MONTH HEALTH SNAPSHOT Prepared by the Australian Physiotherapy Association ABOUT THE TRADIES NATIONAL HEALTH MONTH SNAPSHOT Marcus Dripps,

More information

1 Risk Factors for Prolonged Disability After Whiplash Injury: A Prospective Study. Spine: Volume 30(4), February 15, 2005, pp 386-391

1 Risk Factors for Prolonged Disability After Whiplash Injury: A Prospective Study. Spine: Volume 30(4), February 15, 2005, pp 386-391 1 Risk Factors for Prolonged Disability After Whiplash Injury: A Prospective Study Spine: Volume 30(4), February 15, 2005, pp 386-391 Gun, Richard Townsend MB, BS; Osti, Orso Lorenzo MD, PhD; O'Riordan,

More information

U N D E R S T A N D I N G PM&R THE ROLE OF PM&R IN PROVIDING QUALITY HEALTHCARE

U N D E R S T A N D I N G PM&R THE ROLE OF PM&R IN PROVIDING QUALITY HEALTHCARE U N D E R S T A N D I N G PM&R THE ROLE OF PM&R IN PROVIDING QUALITY HEALTHCARE Understanding the Role of PM&R: Providing Quality Healthcare What is PM&R? Physical Medicine and Rehabilitation Established

More information

Achieving Quality and Value in Chronic Care Management

Achieving Quality and Value in Chronic Care Management The Burden of Chronic Disease One of the greatest burdens on the US healthcare system is the rapidly growing rate of chronic disease. These statistics illustrate the scope of the problem: Nearly half of

More information

Application of Information Systems and Secondary Data. Lynda Burton, ScD Johns Hopkins University

Application of Information Systems and Secondary Data. Lynda Burton, ScD Johns Hopkins University This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike License. Your use of this material constitutes acceptance of that license and the conditions of use of materials on this

More information

The role of t he Depart ment of Veterans Affairs (VA) as

The role of t he Depart ment of Veterans Affairs (VA) as The VA Health Care System: An Unrecognized National Safety Net Veterans who use the VA health care system have a higher level of illness than the general population, and 60 percent have no private or Medigap

More information

Updates into Therapeutic Exercise Programs for Patients with LBP. Maximizing Patient Motivation and Outcomes Alice M.

Updates into Therapeutic Exercise Programs for Patients with LBP. Maximizing Patient Motivation and Outcomes Alice M. Updates into Therapeutic Exercise Programs for Patients with LBP Maximizing Patient Motivation and Outcomes Alice M. Davis, PT, DPT Objectives Review Statistics on LBP Discuss current research findings

More information

Clinical Reasoning The patient presents with no red flags and no indications of maladaptive behaviour in regard to fear avoidance.

Clinical Reasoning The patient presents with no red flags and no indications of maladaptive behaviour in regard to fear avoidance. The McKenzie Institute International 2014 Vol. 3, No. 3 CASE REVIEW: A CLINICIAN S PERSPECTIVE Case Review: 35-Year-Old Male with History of Low Back Pain Brian Østergaard Sørensen, PT, Dip.MDT Introduction

More information

Module 5: Bill s Search for Lois

Module 5: Bill s Search for Lois COMPANION GUIDE Module 5: Bill s Search for Lois Tips for facilitators: Watch the Module 5 DVD prior to the training so that you can anticipate questions and identify supplementary materials needed for

More information

WHY PEOPLE WITH DENTAL INSURANCE SKIP ORAL HEALTH CHECKUPS

WHY PEOPLE WITH DENTAL INSURANCE SKIP ORAL HEALTH CHECKUPS 2014 Cigna Research Study WHY PEOPLE WITH DENTAL INSURANCE SKIP ORAL HEALTH CHECKUPS Key insights into the barriers to preventive dental care. SM Together, all the way. Offered by: Cigna Health and Life

More information

For Technical Assistance with HCUP Products: Email: hcup@ahrq.gov. Phone: 1-866-290-HCUP

For Technical Assistance with HCUP Products: Email: hcup@ahrq.gov. Phone: 1-866-290-HCUP HCUP Projections 2003 to 2012 Report # 2012-03 Contact Information: Healthcare Cost and Utilization Project (HCUP) Agency for Healthcare Research and Quality 540 Gaither Road Rockville, MD 20850 http://www.hcup-us.ahrq.gov

More information

Treatment of Chronic Pain: Our Approach

Treatment of Chronic Pain: Our Approach Treatment of Chronic Pain: Our Approach Today s webinar was coordinated by the National Association of Community Health Centers, a partner with the SAMHSA-HRSA Center for Integrated Health Solutions SAMHSA

More information

Chronic Pain Management in an Ambulatory Setting. practice, and an abrogation of a fundamental human right. (1)

Chronic Pain Management in an Ambulatory Setting. practice, and an abrogation of a fundamental human right. (1) Kristy Goodman NMF-GE Project Summary August 31, 2012 Chronic Pain Management in an Ambulatory Setting The unreasonable failure to treat pain is viewed worldwide as poor medicine, unethical practice, and

More information

Medical College of Georgia Augusta, Georgia School of Medicine Competency based Objectives

Medical College of Georgia Augusta, Georgia School of Medicine Competency based Objectives Medical College of Georgia Augusta, Georgia School of Medicine Competency based Objectives Medical Knowledge Goal Statement: Medical students are expected to master a foundation of clinical knowledge with

More information

Cenpatico STRS POLICIES & PROCEDURES. Effective Date: 07/11/11 Review/Revision Date: 07/11/11, 09/21/11

Cenpatico STRS POLICIES & PROCEDURES. Effective Date: 07/11/11 Review/Revision Date: 07/11/11, 09/21/11 Page 1 of 14 SCOPE: Clinical Department IMPORTANT REMINDER This Clinical Policy has been developed by appropriately experienced and licensed health care professionals based on a thorough review and consideration

More information

Dr. Anna M. Acee, EdD, ANP-BC, PMHNP-BC Long Island University, Heilbrunn School of Nursing

Dr. Anna M. Acee, EdD, ANP-BC, PMHNP-BC Long Island University, Heilbrunn School of Nursing Dr. Anna M. Acee, EdD, ANP-BC, PMHNP-BC Long Island University, Heilbrunn School of Nursing Overview Depression is significantly higher among elderly adults receiving home healthcare, particularly among

More information

Diagnosis and Management for Chronic Back Pain: Critical for your Recovery

Diagnosis and Management for Chronic Back Pain: Critical for your Recovery Diagnosis and Management for Chronic Back Pain: Critical for your Recovery Dr. Connie D Astolfo, DC, PhD (candidate) In past articles I have stressed that the causes of back pain can be very complex. This

More information

Management of Concussion/Mild Traumatic Brain Injury - Evidence Based Practice

Management of Concussion/Mild Traumatic Brain Injury - Evidence Based Practice Management of Concussion/Mild Traumatic Brain Injury - Evidence Based Practice Introduction 1) The Centers for Disease Control and Prevention has estimated that each year, approximately Americans survive

More information

Louisiana Report 2013

Louisiana Report 2013 Louisiana Report 2013 Prepared by Louisiana State University s Public Policy Research Lab For the Department of Health and Hospitals State of Louisiana December 2015 Introduction The Behavioral Risk Factor

More information

American Industrial Hygiene Association Position Statement on Ergonomics

American Industrial Hygiene Association Position Statement on Ergonomics American Industrial Hygiene Association Position Statement on Ergonomics The American Industrial Hygiene Association (AIHA) believes that ergonomics is a multidisciplinary science whose primary focus is

More information

http://nurse practitioners and physician assistants.advanceweb.com/features/articles/alcohol Abuse.aspx

http://nurse practitioners and physician assistants.advanceweb.com/features/articles/alcohol Abuse.aspx http://nurse practitioners and physician assistants.advanceweb.com/features/articles/alcohol Abuse.aspx Alcohol Abuse By Neva K.Gulsby, PA-C, and Bonnie A. Dadig, EdD, PA-C Posted on: April 18, 2013 Excessive

More information

2016 PQRS OPTIONS FOR INDIVIDUAL MEASURES: REGISTRY ONLY

2016 PQRS OPTIONS FOR INDIVIDUAL MEASURES: REGISTRY ONLY Measure #65 (NQF 0069): Appropriate Treatment for Children with Upper Respiratory Infection (URI) National Quality Strategy Domain: Efficiency and Cost Reduction 2016 PQRS OPTIONS FOR INDIVIDUAL MEASURES:

More information

PREVENTIVE MEDICINE AND SCREENING POLICY

PREVENTIVE MEDICINE AND SCREENING POLICY REIMBURSEMENT POLICY PREVENTIVE MEDICINE AND SCREENING POLICY Policy Number: ADMINISTRATIVE 238.13 T0 Effective Date: January 1, 2016 Table of Contents APPLICABLE LINES OF BUSINESS/PRODUCTS... APPLICATION...

More information

Medical History and Technical Standards Form

Medical History and Technical Standards Form Physical Examinations Effective with the 2001-2002 UWF Catalog, any student applying to enter the Athletic Training Education Program must complete a comprehensive physical examination by a licensed physician.

More information

http://www.cms.hhs.gov/therapyservices/

http://www.cms.hhs.gov/therapyservices/ The Centers for Medicare & Medicaid Services (CMS) Web site address referenced on page 1 and page 4 of the following report has changed. The new address is: http://www.cms.hhs.gov/therapyservices/ ~~~~

More information